113 articles - From Friday Jun 23 2023 to Friday Jun 30 2023
Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…
| Am J Gastroenterol |
| Hepatology |
| J Hepatol |
Clinical Practice Guidelines on Hepatitis Delta Virus. Acute infection may associate with acute liver failure, while persistent infection is mostly accompanied by chronic hepatitis with a severe, progressive course leading to cirrhosis and its end-stage complications, hepatic decompensation and hepatocellular carcinoma. Major diagnostic and therapeutic innovations that are under way for HDV infection prompted the EASL Governing Board to establish specific Clinical Practice Guidelines setting out the identification of HDV-infected persons, their virologic and clinical characterization, prognostic assessment and appropriate clinical and therapeutic management. |
EASL Clinical Practice Guidelines on acute-on-chronic liver failure. The recommendations are graded according to the Oxford Centre for Evidence-Based Medicine system and categorized as 'weak' or 'strong'. We aim to provide the best available evidence to aid the clinical decision-making process in the management of patients with ACLF. |
meta-analyses and systematic reviews
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
Detection of changes in regional colonic fermentation in response to supplementing a low FODMAP diet with dietary fibres by hydrogen concentrations, but not by luminal pH. A modest increase in fermentable plus poorly fermented fibres had minor effects on faecal measures of fermentation, despite increases in plasma SCFA and abundance of fermentative bacteria, but the gas-sensing capsule, not pH-sensing capsule, detected the anticipated propagation of fermentation distally in the colon. The gas-sensing capsule technology provides unique insights into localisation of colonic fermentation. |
Effect of different PD-1 inhibitor combination therapies for unresectable intrahepatic cholangiocarcinoma. Among patients with uICC, ICI-chemo or ICI-target provided more survival benefits than Chemo while achieving comparable prognoses and fewer adverse events than ICI-target-chemo. |
Epidemiology and risk factors for histopathologic characteristics of non-alcoholic fatty liver disease in South America. In the largest NAFLD cohort study to date from South America, metabolic syndrome, hypertension and T2DM were independently associated with significant fibrosis, severe steatosis, and inflammation. The prevalence of T2DM was lower than the reported global prevalence. |
| Am J Gastroenterol |
Small-bowel transit scintigraphy in children with paediatric intestinal pseudo-obstruction. SBS provides a practically feasible assessment of small intestinal motility. It shows a potential utility to help diagnose and characterise PIPO. SBS appears most discriminative in PIPO patients with myopathic involvement. Studies in a larger paediatric population and across different ages are required. |
| Endoscopy |
EUS-guided gastroenterostomy with lumen-apposing metal stents: a retrospective, multicentric comparison of wireless and over-the-wire techniques. The WEST has a higher technical success and less AEs, with a clinical success comparable to the DTOG. Therefore, the WEST technique (with an oro-intestinal drain) should be preferred to perform EUS-GE. |
UNDERWATER CAP-SUCTION PSEUDOPOLYP FORMATION FOR ENDOSCOPIC MUCOSAL RESECTION, A SIMPLE TECHNIQUE FOR TREATING FLAT, APPENDICEAL ORIFICE OR ILEOCECAL VALVE COLORECTAL LESIONS. Our findings suggest that CAP-UEMR is a safe and effective technique for removing nonpolypoid colorectal lesions, including those arising from the appendiceal orifice or ileocecal valve. |
| Gastroenterology |
Prevalence of liver steatosis and fibrosis in the general population and various high-risk populations: a nationwide study with 5.7 million adults in China. A substantial burden of liver steatosis and fibrosis was found in China. Our study provides evidence for shaping future pathways for screening and risk stratification of liver steatosis and fibrosis in the general population. The findings of this study highlight that fatty liver and liver fibrosis should be included in disease management programs as targets for screening and regular monitoring in high-risk populations, especially in those with diabetes. |
| Gastrointest Endosc |
CLINICAL OUTCOMES AND LEARNING CURVE FOR ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY DURING ADVANCED ENDOSCOPY TRAINING: A COMPARISON OF SUPINE VERSUS PRONE POSITIONING. Shorter procedure and room turnover times, and a comparable cannulation rate were found for supine vs prone ERCP. |
Expanded indication for endoscopic ultrasound-guided radiofrequency ablation: management of adrenal tumors. EUS-RFA showed high technical feasibility, clinical success, and an acceptable safety profile in the treatment of left adrenal tumors. In patients at high surgical risk, EUS-RFA can be considered as an alternative therapeutic modality to surgery for the treatment of left adrenal tumors. |
Harnessing Language Models for Streamlined Post-Colonoscopy Patient Management: A Novel Approach. Results suggest that ChatGPT could aid healthcare providers in making informed decisions and improve adherence to post-colonoscopy surveillance guidelines. Future research should investigate integrating ChatGPT into electronic health record systems and evaluating its effectiveness in different healthcare settings and populations. |
Long-term Outcomes Following Successful Endoscopic Treatment of T1 Esophageal Adenocarcinoma: A Multicenter Cohort Study. Following successful EET of T1 EAC, neoplastic recurrence occurred after 5 years in 8.3% of cases. Careful long-term surveillance should be continued in this patient population. CE-IM should be the therapeutic endpoint for EET. |
Precise Application of Topical Tranexamic Acid to Enhance Endoscopic Hemostasis for Peptic Ulcer Bleeding: A Randomized Controlled Study. The precise delivery of topical TXA alongside standard endoscopic hemostasis reduced the early treatment failure rate in patients with bleeding peptic ulcers. |
| Gut |
Persistent villous atrophy predicts development of complications and mortality in adult patients with coeliac disease: a multicentre longitudinal cohort study and development of a score to identify high-risk patients. Risk of complications and mortality were increased in patients with pVA. We developed a score to identify patients at risk of pVA and in need of histological reassessment and closer follow-up. |
| Hepatology |
Role of microbiome in autoimmune liver diseases. Herein, we propose future research priorities, which should involve clinical trials, extensive molecular phenotyping at high resolution, and experimental studies in model systems. Overall, autoimmune liver diseases are characterized by an altered microbiome, and interventions targeting these changes hold promise for improving clinical care based on the emerging field of microbiota medicine. |
Seladelpar efficacy and safety at 3 months in patients with primary biliary cholangitis: ENHANCE, a phase 3, randomized, placebo-controlled study. Patients with primary biliary cholangitis (PBC) with inadequate response or intolerance to UDCA who were treated with seladelpar 10 mg had significant improvements in liver biochemistry and pruritus. Seladelpar appeared safe and well tolerated. |
Single-cell RNA sequencing reveals the immunoregulatory roles of PegIFN-a in patients with chronic hepatitis B. Collectively, our study expands the understanding of the pathological characteristics of CHB and the immunoregulatory roles of PegIFN-a, which provides a new powerful reference for the clinical diagnosis and treatment of CHB. |
| J Hepatol |
A global research priority agenda to advance public health responses to fatty liver disease. Adopting this multidisciplinary consensus-built research priorities agenda can deliver a step-change in addressing fatty liver disease, mitigating against its individual and societal harms and proactively altering its natural history through prevention, identification, treatment, and care. This agenda should catalyse the global health community's efforts to advance and accelerate responses to this widespread and fast-growing public health threat. Impact and implications An estimated 38% of adults and 13% of children and adolescents worldwide have fatty liver disease, making it the most prevalent liver disease in history. Despite substantial scientific progress in the past three decades, the burden continues to grow, with an urgent need to advance understanding of how to prevent, manage, and treat the disease. Through a global consensus process, a multidisciplinary group agreed on 28 research priorities covering a broad range of themes, from disease burden, treatment, and health system responses to awareness and policy. The findings have relevance for clinical and non-clinical researchers as well as funders working on fatty liver disease and non-communicable diseases more broadly, setting out a prioritised, ranked research agenda for turning the tide on this fast-growing public health threat. |
A Phase 2a active-comparator-controlled study to evaluate the efficacy and safety of efinopegdutide in patients with nonalcoholic fatty liver disease. In patients with NAFLD, treatment with efinopegdutide 10 mg weekly led to a significantly greater reduction in LFC than semaglutide 1 mg weekly. (EudraCT 2020-005136-30; NCT 04944992) IMPACT AND IMPLICATIONS Currently, there are no approved therapies for nonalcoholic steatohepatitis (NASH). The weight loss associated with glucagon-like peptide-1 (GLP-1) receptor agonists has been shown to decrease hepatic inflammation in patients with NASH. In addition to reducing liver fat content (LFC) indirectly through weight loss, glucagon receptor agonism may also reduce LFC by acting on the liver directly to stimulate fatty acid oxidation and reduce lipogenesis. This study demonstrated that treatment of nonalcoholic fatty liver disease (NAFLD) patients with the GLP-1/glucagon receptor co-agonist efinopegdutide at 10 mg weekly led to a significantly greater reduction in LFC compared with the GLP-1 receptor agonist semaglutide at 1 mg weekly, suggesting that efinopegdutide may be an effective treatment for NASH. Clinical trial number EudraCT 2020-005136-30; NCT 04944992. |
Ductular reaction-associated neutrophils promote biliary epithelium proliferation in chronic liver disease. Overall, our study reveals the accumulation of DRANs as a hallmark of advanced liver disease and a potential therapeutic target to mitigate ductular reaction and maladaptive wound-healing response. Impact and implications Our results indicate that neutrophils are highly plastic and can have an extended lifespan. Moreover, we identify a new role of neutrophils as triggers of expansion of the biliary epithelium. Overall, the results of this study indicate that ductular reaction-associated neutrophils (DRANs) are new players in maladaptive tissue healing response in chronic liver injury and may be a potential target for therapeutic interventions to reduce ductular reaction expansion and promoting tissue repair in advanced liver disease. |
Evaluation and comparison of risk-based and universal prenatal HCV screening programs in Alberta, Canada. Universal HCV screening diagnoses significantly higher numbers of pregnant individuals infected with HCV compared to risk-based screening. Universal HCV screening or amending risk-based guidelines to incorporate more proxy variables for risk factors should be considered to improve prenatal HCV screening guidelines in Canada and help achieve HCV elimination in the next decade. Impact and implications Hepatitis C virus (HCV) is a bloodborne pathogen that can cause severe liver disease and be vertically transmitted from a mother to her baby during pregnancy. Pregnant individuals in Alberta are currently only tested for HCV if they disclose to their physician engagement in activities that put them at risk for acquiring the infection (risk-based screening). Using a population-wide universal prenatal HCV screening program, our work shows testing based on patient disclosed risk alone significantly underdiagnoses HCV in pregnant individuals and suggests individuals engaging in sex work or risky sexual behaviours are being overlooked with the current risk-based program. Our outcomes represent the first province-wide study to evaluate and compare prenatal HCV risk-based and universal screening programs in Canada and can be used as evidence-based data for updating prenatal HCV screening policies across the country and in similar jurisdictions. |
GARP on hepatic stellate cells is essential for the development of liver fibrosis. GARP expressed on HSCs drives the development of liver fibrosis via cell contraction-mediated activation of latent TGF-ß. Considering that systemic blockade of TGF-ß has major side effects, we highlight a therapeutic niche provided by GARP and surface-mediated TGF-ß activation. Thus, our findings suggest an important role of GARP on HSCs as a promising target for the treatment of liver fibrosis. Impact and implications Liver fibrosis represents a substantial and increasing public health burden globally, and specific treatments are not available. Here, we show that the protein GARP expressed on hepatic stellate cells (HSCs) drives the development of liver fibrosis. Our findings suggest GARP as a novel target for future therapies of fibrotic disease. |
Liver disease is a significant risk factor for cardiovascular outcomes - a UK Biobank study. Liver disease activity, by cT1, was independently associated with higher risk of incident CVD and all-cause mortality, independent of pre-existing metabolic syndrome, liver fibrosis or fat. Impact and implications Chronic liver disease(CLD) is associated with two-fold greater incidence of cardiovascular disease(CVD). Our work shows that early liver disease on cardiac MRI (by cT1) was associated with higher risk of major CVD(14%), CVD hospitalisation(27%) and all-cause mortality(19%). Whether for patients, carers, clinicians, and policymakers, there are implications for early prevention of CLD and CVD. |
| Neurogastroenterol Motil |
The integrated relaxation pressure may not be an appropriate gold standard for deglutitive relaxation due to reliance on a single intragastric reference sensor. IRP values can vary greatly depending on the reference sensor used, leading to inconsistent diagnoses in 28% of HRM studies. Choosing the correct gastric reference sensor is crucial for accurate test results and avoiding misdiagnosis. Standardization of reference sensor selection or supportive testing for uncertain results should be considered. |
Visceral hypersensitivity induced by mild traumatic brain injury via the corticotropin-releasing hormone receptor: An animal model. LISW provoked visceral hypersensitivity, small intestinal hyperpermeability, altered expression of CRFRs and changes in the microbiota, suggesting that genuine bTBI caused by LISW can induce a pathophysiology comparable to that of human IBS. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Aliment Pharmacol Ther |
Review article: Translating STRIDE-II into clinical reality - Opportunities and challenges. Prospective studies, objective criteria for risk stratification, and better predictors of therapeutic response are needed to potentially render 'treating to target' more effective in the future. |
| Clin Gastroenterol Hepatol |
| Gut |
Drug rediscovery in gastroenterology: from off-label to on-label use of thioguanine in inflammatory bowel disease. In this paper, we aim to visualise potential hurdles that hamper drug rediscovery in general, emphasise the global need for optimal use and development of potentially useful drugs, and provide an overview of the registration process for TG in the Netherlands. With this summary, we aim to guide drug rediscovery trajectories in the near future. |
| J Hepatol |
Guidance on treatment endpoints and study design for clinical trials aiming to achieve cure in chronic hepatitis B and D: Report from the 2022 AASLD-EASL HBV/HDV treatment endpoints conference. Novel biomarkers (HBcrAg, HBV RNA) remain exploratory while nucleos(t)ide analogues and pegylated interferon still have a role in combination with novel agents. Importantly, patient input is encouraged early on in drug development under the FDA/EMA patient-focused drug development programs. |
misc publications eg case reports, tools of the trade, images of the month, etc…
| Am J Gastroenterol |
| Clin Gastroenterol Hepatol |
| Endoscopy |
| Gastroenterology |
| Gastrointest Endosc |
| Gut |
| Hepatology |
Letters to the editors and authors’ replies
| Aliment Pharmacol Ther |
| Gastroenterology |
| Gut |
| J Hepatol |